Hospitals becoming accountable While adverse events result in substantial costs, hospitals bear only a small proportion of these costs and therefore have few financial incentives to invest in patient safety interventions. On average, hospitals externalized 78% of the costs of all injuries and 70% of the costs of negligent
injuries. Patient safety advocates are seeking to make a business case to demonstrate that if health care organizations invest in safer practices and systems, they will reap financial returns in the form of reduced malpractice costs and other expenses (Tanne, 2008).
TYPES OF MEDICAL ERRORS
Medical errors represent a serious public health problem and pose a threat to patient safety. All patients are Misdiagnosis of symptoms Misdiagnosis includes a failure to diagnose an underlying condition. This could ultimately lead to medical malpractice if the undiagnosed disease causes damage, disability, or even death. Incorrect diagnoses have the potential of administering incorrect, ineffective treatment or unnecessary testing. Incorrect diagnosis may be costly and invasive but for the patient it will have far greater consequences (Rodziewicz et al., 2023). Errors in medication Medication errors alone account for at least 1.5 million preventable adverse drug events annually in the United States. Errors in medication are propelled by numerous human interaction points. Four stages of medication process The pathway connecting a clinician's decision to prescribe a medication and the patient actually receiving the medication consists of several steps (AHRQ, n.d): ● Ordering : The clinician must select the appropriate medication and the dose, frequency, and duration. ● Transcribing : In a paper-based system, an intermediary (a clerk in the hospital setting, or a pharmacist or pharmacy technician in the outpatient setting) must read and interpret the prescription correctly. ● Dispensing : The pharmacist must check for drug–drug interactions and allergies, then release the appropriate quantity of the medication in the correct form. ● Administration : The correct medication must be supplied to the correct patient at the correct time. In hospitals or long-term care settings, this is generally the responsibility of nurses or other trained staff; in Adverse drug event Adverse drug events (ADEs) cause injury and mortality and remain underappreciated and misunderstood. Studies show that over 770,000 people are injured or die each year in hospitals from adverse drug events. National hospital expenses to treat patients who suffer ADEs during hospitalization are estimated at between $1.56 and $5.6 billion annually (Slight et al., 2018). Adverse drug reaction ADEs can result in a number of different physical consequences, ranging from allergic reactions to death. The most common medications involved in ADEs were cardiovascular (median 38%), nervous system (median 16.5%), and anti-infectives (median 14.5%) (Insani et al., 2021). It remains difficult to anticipate who will suffer an ADE or when, and from what medication. The reason for this is that research has not yet identified any valid predictors of the ADEs. Even current patient characteristics are not useful predictors of an ADE because patients who have suffered ADEs are not in some special elite group.
potentially vulnerable, therefore medical errors are costly from a human, economic, and social viewpoint.
Under-diagnosis Under-diagnosis is common for conditions with either no symptoms or vague, mild symptoms. The medical professional may also have a lack of proper understanding about a particular condition which leads to under-diagnosis. Under-diagnosis may occur for conditions that are rare or simply do not get much consideration by patients or doctors. (Hall et al., 2020). ambulatory care the responsibility falls to patients or caregivers. Each of these four stages is subject to human interaction points, allowing for multiple opportunities for error. The three methods used in ferreting out errors in the medication process are (Lisby et al., 2005): 1. Direct observations. 2. Unannounced control visits. 3. Chart reviews. The vulnerability of human interaction points in the process remains present. The differences are as follows. Direct observation puts four eyes on the event rather than just two. Unannounced controlled visits permit someone coming in front of, during, or following a treatment or administration of medication. That quantifies what will occur, what is occurring, or what has occurred. Bringing those three elements together will hedge results or more likely pinpoint medical errors at a later date. Chart reviews will be a motivating factor for the medical professionals to more accurately report and document. Small slips will be identified before a catastrophic event occurs. Medication error Medication errors cause at least one death every day and injure approximately 1.5 million people annually in the United States (Lahue et al., 2012). Medication mishaps can occur anywhere in the distribution system. There are five distribution systems: 1. Prescribing. 2. Repackaging. 3. Dispensing. 4. Administering. 5. Monitoring. The volatility that this represents is that there are human factors associated with each of the five distribution systems. The Center for Drug Evaluation and Research (CDER) began receiving reports of medication errors in January 1992, when the U.S. Pharmacopeia began forwarding reports to the FDA. CDER responsibilities are not completed when the safety and effectiveness of a drug product are determined. It also has the responsibility for helping to ensure the safe use of the drugs it approves by identifying and avoiding proprietary names (among other things) that contribute to
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